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Common Mistakes When Filling Out Workers’ Comp Claims

Most injured workers report the injury to their employer and go to the hospital. Then, they start working with their HR Department to navigate the process of getting their wages and medical bills paid while they recover. Many workers make the mistake of following L&I’s or their employer’s instructions without asking the right questions or considering the consequences. Any mistakes made early on in the claim can spell disaster for the claim down the road. If you’ve been injured, don’t make these costly mistakes.

Not Reporting Right Away or Downplaying the Injury

Most injured workers report the injury to their employer and go to the hospital, but many don’t. They might downplay the injury to their supervisors or coworkers out of fear, or they want to see how badly they’re hurt before they report or file their L&I claim. They worry whether filing will affect their career or income. A lot of workers use vacation or sick time instead of using the workers’ comp system. Sometimes the boss persuades an injured worker not to file, knowing that an L&I claim could increase the employer’s workers’ comp costs. And worse yet, some don’t even report their injury at all.

How to Fix It

If you want the best chance of getting workers’ comp, you need to report the injury and start the L&I claim process right away. Not reporting an injury right away or delaying filing the L&I claim is a big mistake. Any delay opens the door for your employer or L&I to question whether you were hurt at work. Your employer and Claim Manager are more likely to support and accept your claim if the injury is reported in real time.

You have one year from the date of your injury to file a claim for L&I benefits, or two years if the injury is an occupational disease. If you miss these deadlines, it’s very likely your claim will be permanently barred by these statutes of limitation.

Seeing The Doctor Your Employer Chooses

Your employer will nearly always recommend a health care provider that tends to serve the company and its interests. Seeing this doctor could result in a medical opinion that doesn’t reflect the true nature or extent of your injuries. And once an unsupportive medical opinion is on the record, it’s difficult to overcome it.

How to Fix It

Simply put, see your own doctor, no matter what your employer says.

Playing The Tough Guy (Or Girl)

When you first see a doctor after the injury, this is the worst time to downplay the pain or to be “brave” in front of your doctor. If you don’t tell the doctor exactly what you are experiencing, the doctor’s records won’t reflect your injuries and pain, and L&I or your employer could use these records to later prove that your injuries and pain are less severe, that you weren’t really injured at all, or that your injuries are the result of something that happened outside of the workplace.

How to Fix It

Be completely honest about the nature and extent of your injuries. Tell the doctor how you were hurt, how badly you are hurt, where you are hurt, and the level of pain you are experiencing.

Forgetting Everything You Say Can Be Used Against You

From the moment you are injured at work, you should expect to be monitored. L&I defense firms regularly use surveillance companies to try to catch an injured worker doing physical activity that contradicts the L&I claim. IME staff and doctors also look for any sign that an injured worker could be overplaying his or her injury. Defense counsel has been known to hire investigators to research and record social media posts and online activity. Employers are incentivized to use resources to fight an L&I claim because accepted claims affect the amount they pay for workers’ comp insurance.

How To Fix It

Your best bet is to hire an experienced workers’ comp attorney. They will have your best interest at heart, and will make sure you are prepared every step of the way through the claims process.

Refusing Work Offered By Your Employer

Being offered light duty work can put you in a very tricky situation. If your employer offers you light duty, it forces you to make a big decision, often in very little time. You may get offered a different position despite the fact that your injury prevents you from doing it. Worse, your employer could force you to give them an answer without time to think. And if you don’t respond, your employer might use your refusal to argue that L&I should deny your claim. Your employer is required to get approval from your doctor for the offer, but the approval can be as simple as a verbal okay.

How To Fix It

If you find yourself in this situation, the first thing you should do is to contact an L&I attorney immediately. The second thing you should do is contact your doctor. If the doctor disagrees with the light duty job in writing, you will have a good argument to L&I that you remain unable to work. In most circumstances, you should not outright refuse an offer for light duty work. Unless you can accept it without issue, you (or your attorney) needs to build your case as to why light duty work is not an option.

Waiting To Appeal An Order

Every L&I decision can be protested or appealed. You have 60 days to appeal or protest an L&I decision. If you miss this important deadline, the decision will likely become final. In short, if you miss an appeal, you’re stuck with the outcome. And a lot of decisions are based on very important issues within an L&I case. Entire cases have been lost because a claimant simply forgot to appeal or protest an adverse decision within the 60-day window.

How To Fix It

If you have the opportunity to appeal, don’t delay! In an ideal world, everyone would get in touch with an L&I attorney as soon as they’re injured. Many of our clients come to us after receiving unhappy news from L&I. While it’s not impossible to turn it around, it’s a lot easier when we’re with you from the beginning.

Returning To Work Too Soon

The best employees want to get back to work as quickly as possible. They want to start producing again and continue moving their careers forward. However, going back to work before you are fully healed can negatively impact your L&I claim. An employer who wants to fight an L&I claim may use the employee’s return to work as evidence that the worker is in fact able to work full time and has healed. Unscrupulous employers sometimes use the period after the injured worker returns to work to PIP the worker until the employee is fired or quits.

How To Fix It

Make certain you are fully healed before you return to work. It can be hard, especially when your income is affected, but trust us – returning to work too soon can negatively impact your case.

Accepting The Wrong Disability Rating

For many claims, L&I issues a disability rating, which determines how much an injured worker will get paid. Who issued the rating? Did the IME provide the rating? Which doctors support it? Are you done treating? Have you truly reached MMI? Do you agree with the rating? Are you ready to go back to work? Are you concerned that you might need another procedure? Do you just need more time to see if you’re healing? These are all important questions that must be answered before you agree to a disability rating. You get one shot at maximizing the amount you receive for your workplace injury, so it’s important that you have the right medical opinion and support to ensure that you receive the highest rating available.

How To Fix It

This is where our L&I attorneys really shine. We’ve tried thousands of workers’ compensation claims throughout Washington state, and we regularly obtain claim approvals, benefits, and exceptionally large awards for our clients. By hiring the right attorney, you can get these questions answered and more.

Not Realizing That Mental Health Issues Are Valid L&I Claims

Some sick or injured workers eventually suffer from depression and other mental health issues. For some, the mental health issue is the injury that is the basis for the L&I claim. Mental health issues are treated similarly to physical injuries when they occur in the workplace. On the other hand, it can be difficult to find a mental health professional capable of supporting a mental health L&I claim. And complicating this matter is that conditions like depression make it hard to find the energy to fight L&I and take the steps necessary to keep a claim open.

How To Fix It

If you find yourself in this situation, reach out to an attorney and explain your situation. An experienced L&I attorney can explain your rights and options, and will seek to represent you if they feel they can fight for your case.

Get Good Advice Sooner Rather Than Later

You can do a lot of damage to your claim without knowing it. A percentage of L&I claims go through without a hitch. You see a doctor and file an L&I claim. The doctor’s report is favorable and L&I accepts the claim. After treatment, your doctor supports the highest category rating possible, you get back to your work right-as-rain and L&I cuts you a large check. This happens, just not very often.

If you’re concerned things might not go well with your L&I claim, chances are that disaster is looming. The key is to get help before adverse orders pile up. A talented L&I attorney can fix a lot of problems with a workers’ comp case that has been mismanaged, but they can’t fix every problem. And sometimes attorneys won’t accept cases where adverse orders have been issued and not protested in time. Good attorneys won’t take cases if they can’t provide you value beyond what you can receive for yourself. If you suspect you might have an issue with your case, call us. Our attorneys will provide a free consultation and tell you if they can help.

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